Symptoms began around mid-June, and several of the patients reported eating at the Italian American Community Center in Albany, Prime Life Restaurant at the Beltrone Senior Living Community Center in Colonie, and a private buffet held at Union College in Schenectady, state health officials said.

While cyclosporiasis is endemic in some areas of the world, outbreaks in the U.S. are often associated with imported fresh produce that have been contaminated with a fecal parasite known as Cyclospora cayetanensis.

People eat more fruit and vegetables in the summer, which might be behind annual outbreaks of cyclosporiasis, officials said. They advise consumers to wash produce carefully and store it in the refrigerator.

State health officials say there is no indication that the parasite was spread by poor food handling or preparation at local establishments, which are cooperating with the investigation. Instead, contamination often occurs prior to arrival at food distribution centers and restaurants, they said, and is not easily removed by standard rinsing.

Additional dining establishments may be identified as the investigation continues, they added.

Health departments in Albany, Montgomery, Saratoga and Schenectady counties are aiding the state in its investigation.

Symptoms of cyclosporiasis appear roughly one to two weeks after ingestion. They include watery diarrhea, loss of appetite, weight loss, stomach cramps, bloating, nausea and fatigue.If left untreated, symptoms can lost a month or longer and can return one or more times.

Infection is generally not transmitted directly from person to person, state health officials say.

Unrelated to the Capital Region outbreak, state health officials say they are closely monitoring an increase in cyclosporiasis cases statewide and nationally.

While cases are reported year-round in the U.S., reports are most common during the spring and summer months, with cases starting around May and peaking in June and July, according to the federal Centers for Disease Control and Prevention.

There have only been 23 cases reported across 10 states from May 1 through June 24 of this year, the CDC reports. Last year, there were 2,299 laboratory-confirmed cases reported across 33 states between May and August.